To measure the specific effectiveness of a given treatment in a randomised controlled trial, the intervention and control groups have to be similar in all factors not distinctive to the experimental ...treatment. The similarity of these non-specific factors can be defined as an equality assumption. The purpose of this review was to evaluate the equality assumptions in manual therapy trials.
Relevant studies were identified through the following databases: EMBASE, MEDLINE, SCOPUS, WEB OF SCIENCE, Scholar Google, clinicaltrial.gov, the Cochrane Library, chiloras/MANTIS, PubMed Europe, Allied and Complementary Medicine (AMED), Physiotherapy Evidence Database (PEDro) and Sciencedirect. Studies investigating the effect of any manual intervention compared to at least one type of manual control were included. Data extraction and qualitative assessment were carried out independently by four reviewers, and the summary of results was reported following the PRISMA statement.
Out of 108,903 retrieved studies, 311, enrolling a total of 17,308 patients, were included and divided into eight manual therapy trials categories. Equality assumption elements were grouped in three macro areas: patient-related, context-related and practitioner-related items. Results showed good quality in the reporting of context-related equality assumption items, potentially because largely included in pre-existent guidelines. There was a general lack of attention to the patient- and practitioner-related equality assumption items.
Our results showed that the similarity between experimental and sham interventions is limited, affecting, therefore, the strength of the evidence. Based on the results, methodological aspects for planning future trials were discussed and recommendations to control for equality assumption were provided.
Objective:
To evaluate nasal cavity (NC) dimensions of individuals with cleft lip and/or palate (CL/P), obstructive sleep apnea (OSA), and primary snoring, by tomographic image analysis, compared to ...individuals with OSA without CL/P (N-CL/P).
Design:
Cross-sectional and retrospective.
Setting:
Tertiary referral center.
Participants:
Patients were divided into 2 groups: (G1) CL/P + OSA or primary snoring, n = 11; (G2) N-CL/P + OSA, n = 13.
Interventions:
NC tomographic images were reconstructed using ITK-SNAP software, and measurements were obtained from these three-dimensional models using SpaceClaim software.
Main Outcome Measures:
Total NC volumes, right and left NC volumes, and volumes of the nostril to the nasal valve (V1) and from the nasal valve to the superior limit of the nasopharynx (V2), cross-sectional areas, and perimeters.
Results:
NC volumes (total, right, and left sides), V1, and V2, though smaller in the CL/P + OSA, did not differ significantly from the N-CL/P + OSA. Cross-sectional areas and perimeters of the superior limit of the nasopharynx, in the CL/P + OSA, presented significantly higher values compared to the N-CL/P + OSA (P ≤ .05).
Conclusions:
The internal nasal dimensions of patients with CL/P do not seem to be part of the etiopathogenesis, nor constitute a risk factor for OSA with greater severity, in this special group of patients.
Pitt-Hopkins Syndrome (PTHS) is a rare genetic disorder caused by insufficient expression of the TCF4 gene. Children with PTHS typically present with gastrointestinal disorders and early severe ...chronic constipation is frequently found (75%). Here we describe the case of a PTHS male 10-year-old patient with chronic constipation in whom Osteopathic Manipulative Treatment (OMT) resulted in improved bowel functions, as assessed by the diary, the QPGS-Form A Section C questionnaire, and the Paediatric Bristol Stool Form Scale. The authors suggested that OMT may be a valid tool to improve the defecation frequency and reduce enema administration in PTHS patients.
Introduction and hypothesis
Chronic pelvic pain syndrome (CPPS) is defined as the occurrence of chronic pelvic pain (CPP) in the absence of a specific cause. People typically refer to pain associated ...with urological, gynaecological, and sexual dysfunction, affecting the quality of life. Therefore, we assessed the effectiveness of myofascial manual therapies (MMT) for pain and symptom impact.
Methods
A systematic review and meta-analysis were conducted. Findings were reported following the 2020 PRISMA statement. Five databases were searched for RCTs. Studies were independently assessed through a standardized form, and their internal validity was evaluated using the Cochrane risk of bias (RoB) tool. Effect sizes (ES) were calculated post-treatment, and the quality of evidence was assessed through GRADE criteria.
Results
Seven articles were included in the review, five of these in the meta-analysis. None of these studies were completely judged at low RoB. MMT was revealed to be not significantly superior for pain reduction ES: –0.54 (–1.16; 0.08);
p
= 0.09, for symptom impact ES: –0.37 (–0.87; 0.13);
p
= 0.15, and for quality of life ES: –0.44 (–1.22, 0.33),
p
= 0.26 compared to standard care. The quality of evidence was “very low”. Other results were presented in a qualitative synthesis.
Conclusions
In patients with CPP/CPPS, MMT is not considered superior to other interventions for pain reduction and symptom impact improvements. However, a positive trend was detected, and we should find confirmation in the future. Further high-quality, double-blinded, sham-controlled RCTs are first necessary to confirm these positive effects and to improve the quality of evidence.
Empathy plays a role in medical care. Studies have showed that higher empathy levels of physicians correlates with better patient outcomes. The role of empathy in osteopathic practice has been poorly ...investigated.
To explore the feasibility of analysing the link between the empathy of osteopaths and the improvement in persistent musculoskeletal pain patients.
13 trainees attending the 5th year in a reference osteopathic teaching institution and 39 patients with chronic musculoskeletal pain.
Trainees were tested for their empathy level by using the Jefferson Scale of Physician Empathy-Health Professional. Trainees with a score higher than the 80th percentile and lower than the 20th percentiles were identified as “highly” and “poorly” empathic therapists and were assigned respectively to the HET and LET group. Each trainee was assigned to patients. Pain intensity was monitored throughout the study by the validated Numerical Rating Scale (NRS).
Patients included into the HET and LET groups had comparable baseline characteristics. Both groups benefited from the treatment. The mean NRS improvement score in the HET group was 6.4 (95% CI 5.3 to 7.5; p < 0.0001). The LET mean NRS improvement score was 3.5 (95% CI 2.1 to 4.8; p < 0.0001). The intergroup difference indicated that the two patient groups differed in pain intensity starting from the third treatment (T3 p = 0.0032 and T4 p = 0.0021).
Research on the link between empathy of therapists and the outcome of Osteopathic Manipulative Treatment for chronic musculoskeletal pain appears feasible. The reported findings might help to design further confirmatory studies.
•Empathic skill involvement in osteopathic clinical practice have not been extensively investigated.•This study suggests that the effect of empathic skills can be investigated.•The topic could be relevant to both professional and academic osteopaths.
Partindo das contribuições da pesquisa em Ensino de Física, Ensino de Ciências e Educação, fizemos uma leitura dos atuais parâmetros e diretrizes curriculares da legislação educacional brasileira ...para incorporar alguns de seus elementos através de projetos interdisciplinares abordando a temática da energia. Desenvolvemos uma revisão históricoconceitual da gênese do conceito de energia e de estudos relacionados à sua transposição didática para o ensino médio. Argumentamos em torno da necessidade de superar-se o ensino centrado apenas na resolução de problemas e no desenvolvimento de modelos físicomatemáticos, da importância de diversificar-se o currículo trabalhando com diferentes ênfases, permitindo uma maior motivação e aumentando as oportunidades de aprendizagem. Discutimos os resultados da implementação de duas propostas de introdução do conceito de energia: uma com ênfase nas relações entre Ciência, Tecnologia, Sociedade e Ambiente (CTSA), e outra com ênfase nas contribuições da História, da Filosofia e da Sociologia da Ciência (HFS). E, finalmente, sugerimos algumas estratégias para dar continuidade ao desenvolvimento da abordagem temática ao longo do 2º ano do ensino médio.
Considering contributions of Physics and Science Education and Education research, we have made a review on the legal Brazilian educational legislation with the aim to implement interdisciplinary curricular projects dealing with the concept of energy. We have done a historical review of the development of this concept and of studies related to didactical approaches targeted to high school level. Our arguments favor the overcoming teaching practices centered on problem solving and mathematical models development. We support the need of several curricular emphases that could motivate and improve student’s learning. We also discuss the results of the implementation of two proposals concerning the introduction of the concept of energy. One was developed with the emphasis on the relation of Science, Technology, Society and Environment, and the other on contributions of History, Philosophy and Sociology of Science. Finally, we suggest some strategies to continue the approach centered in a specific theme during the second year of high school.
Thesis (M.A.)--University of Wisconsin--Madison, 1954.
Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves ...62-63).
Pitt-Hopkins Syndrome (PTHS) is a rare genetic disorder caused by insufficient expression of the TCF4 gene. Children with PTHS typically present with gastrointestinal disorders and early severe ...chronic constipation is frequently found (75%). Here we describe the case of a PTHS male 10-year-old patient with chronic constipation in whom Osteopathic Manipulative Treatment (OMT) resulted in improved bowel functions, as assessed by the diary, the QPGS-Form A Section C questionnaire, and the Paediatric Bristol Stool Form Scale. The authors suggested that OMT may be a valid tool to improve the defecation frequency and reduce enema administration in PTHS patients.
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